Pre-Qualification Procedure For 3rd Party Consultant For Carrying

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					         PORTS, CUSTOMS & FREE ZONE CORPORATION
              ENVIRONMENT, HEALTH & SAFETY

        PRE-QUALIFICATION FORM – RA CONSULTANTS



Pre-Qualification Form:
RISK ASSESSMENT
STUDY Consultants
Name and Address of Consultants:




Date:
                    PRE-QUALIFICATION FORM – RA CONSULTANTS


Notes to Applicants
      o   Please type or print your replies legibly.
      o   Enter the date on which you complete the questionnaire at the bottom of each page.
      o   Please answer all questions. If the question does not apply to you, please put “NA” (Not
          Applicable).
      o   Please include all attachments (additional pages) in the related sections e.g. Section D
          attachments shall be D1, D2 or D3, …..…. etc.
      o   The following are guidelines for consultants seeking to perform consultancy services for
          PCFC & Dubai World Jurisdiction.

General:

1.        Registration with PCFC is required for all Environment, Health & Safety consultants who
          intend to work for PCFC & Dubai World jurisdictional areas. EHS will maintain information
          on the qualifications and capabilities of registered consultants in its information system.
2.        Consultants who are seeking registration with EHS shall submit the application with
          following documents :
          2.1     Introduction letter addressed to the COO, Environment Health & Safety- Ports,
                  Customs & Free Zone Corporation, providing a general brief on your firm.
          2.2     One copy of the attached questionnaire fully completed and signed by an Authorized
                  representative.
          2.3     Copy of the supporting documents. Agencies to complete the format covering all
                  details and submit for approval.
3.        The processing fee of AED 10,000/- for New Application payable by cash or cheque addressed
          to PORTS CUSTOMS & FREE ZONE CORPORATION will be required to be paid for the
          Registration, which will be valid for one year.
          For Renewable of Registration, every year a fees of AED 5,000/- will be required to be paid.
4.        Copy of valid Trade License issued from Chamber of Commerce should be attached.
5.        Copy of ISO/quality Certification should be submitted.
6.        Premises/office could be inspected by EHS at any time during the year.
7.        The company person should have an insurance coverage for the professional liability. Please
          provide details and attach a copy of the policy.
8.        CVs of all locally available engineers/ consultants whose names are required to be listed in
          the approved list and passport copy with evidence of UAE residence (passport copy with
          visa page).
9.        Attested copies of academic and professional qualification/certifications.
10.       Approval from other authorities.
11.       Proven track record summary for major relevant studies.




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                  PRE-QUALIFICATION FORM – RA CONSULTANTS

Table of Contents

Please list below any additional pages attached with the Application Form.

        List                                               Page No.

1.0     General Information                                Page 4

2.0     Range of Engineering Specialties                   Page 5

3.0     Operating Resources                                Page 6

4.0     Human Resources                                    Page 7

5.0     Resume Format                                      Page 8

6.0     Experience/Past Performance                        Page 9

7.0     Organization & Management                          Page 10

8.0     Quality                                            Page 11




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                  PRE-QUALIFICATION FORM – RA CONSULTANTS

1.0     General Information
1.      Name of the Company         :

        Address                     :

        Telephone Numbers                  :

        Fax Number                  :

        E-Mail                      :

2.      Contact Person Name         :

        Designation                 :

        Mobile Telephone No.        :

3.      Courier Address             :

4.      Location Plan               : Please attach location plan to show existing office.

5.      Bank Information            :

            o Bank Name

            o Address

            o Contact Name

            o Telephone No.




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              PRE-QUALIFICATION FORM – RA CONSULTANTS

2.0     Range of Engineering Specialties
Please mark down on the table the type of services offered with respect to each
discipline which best describes your Consultancy services in accordance with your
commercial registration license/certificate. Please indicate ONLY those services of
which you have appropriate experience and expertise, which can be verified by EHS.

Type of activities Provided:
 SL.               Discipline               Planning Design Supervision Audits
2.1    Commercial Facilities
2.2    Residential Facilities
2.3    Industrial Facilities
2.4    General Warehousing Facilities
2.5    Dangerous Goods Warehousing
2.6    Petrochemical Industries
2.7    Oil Refinery
2.8    LP Gas Man/Storage/filling
2.9    Chemical Storage Tanks
2.10   Tobacco Industries
2.11   Hotel Industries
2.12   Institutional Facilities
2.13   Radioactive
2.14   Rail Roads
2.15.  Ports & Marine Industries
2.16   Container Terminal
2.17   Construction Industries
2.18   Power Stations/Sub Stations
2.19   Textile Industries
2.20.  Cement Industries
2.21   Steel Industries
2.22   Occupational Health




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                   PRE-QUALIFICATION FORM – RA CONSULTANTS

3.0      Operating Resources

Please provide details of the operating resources available within your firm.
3.1    Hardware
 Item
  No.                Hardware                      Number             Type             Capacity

 3.1.1      Workstation

 3.1.2      Computers

 3.1.3      Monitors

 3.1.4      Scanners

 3.1.5      Plotters/Colour Printers

 3.1.6      GPS Surveying Stations

 3.1.7      Monitoring Equipment

 3.1.8  Others *
3.2    Software

 No.                      Discipline                             Software                      Version

3.2.1       Fire & Explosion Index Modeling

3.2.2       Toxicity & Dispersion Index Modeling

3.2.3       Consequence Modeling

3.2.4       Heat Radiation Modeling

3.2.5       Drawing

3.2.6       Planning/Scheduling

3.2.10      Others (Specify)




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                PRE-QUALIFICATION FORM – RA CONSULTANTS

4.0     Human Resources

Please indicate the availability of the following professionals. Please note C.V. in the
attached format is required for all the professionals.

        No. of Technical Staff            :
        No. of Administration Staff       :

                                                                                    Work
  SL.        Professional Discipline          Availability        Number          Experience
  No.                                           Yes/No                      Intl.    Gulf    UAE
4.1      Fire Engineer
4.2      Environmental Engineer
4.3      Safety Engineer
4.4      Chemical Engineer
4.5      Mechanical Engineer
4.6      Marine Engineer
4.7      Structural Engineer
4.8      Civil Engineer
4.9      Draughtsman/CAD Operator
4.10     Administration Staff
4.11     Accountant
4.12     Others *
* To be listed out




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                 PRE-QUALIFICATION FORM – RA CONSULTANTS

5.0       Resume Format


    1.      POSITION                        :

    2.      NAME                            :

    3.      DATE OF BIRTH                   :

    4.      NATIONALITY                     :

    5.      EDUCATION QUALIFICATION:                 (State the name of the institution,
            its location and the year the qualification obtained)

    6.      OTHER PROFESSIONAL TRAINING:

    7.      LANGUAGE AND DEGREE OF                  :
            PROFICIENCY

    8.      MEMBERSHIP OF PROFESSIONAL                      :
            SOCIETIES

    9.      EXPERIENCE WITH CURRENT COMPANY                              :

    10.     WORK EXPERIENCE
            IN THE UAE.                     :

    11.     WORK EXPERIENCE
            IN THE GULF                     :

    12.     WORK EXPERIENCE
            IN OTHER COUNTRIES              :

    13.     CURRENT BASE ADDRESS :




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                 PRE-QUALIFICATION FORM – RA CONSULTANTS

6.0     Experience/Past Performance

6.1     Length In Business
Please confirm the number of years experience as a Consultant Engineer

        International                          Gulf                          UAE



6.2     DETAILS OF INVOLVEMENT IN MAJOR PROJETS IN LAST 2 YEARS)
SI.                                        Client
No      Project Name       Location                     Project        Project       Duties
                                                        Value        Description   Performed

 1


 2



 3



 4


 5



 6



 7

* Additional Sheets may be used if required.


6.3     Record of Claims/Arbitration
        Please provide 5 year record of Claims/Arbitration with your major Clients.




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                 PRE-QUALIFICATION FORM – RA CONSULTANTS

7.0      Organization and Management

7.1      Trade License
         Please provide details of UAE Trade License (attach copy)

7.2   Pre-qualifications
      Please provide details of Pre-qualifications with International Gulf/UAE
Organization.

7.3      Organization Chart
         Please indicate here or attach organization chart showing the company
         structure showing the positions of directors and all key personnel.

7.4      Manager in-charge
         Please indicate here the manager in-charge of the consultancy office and
         attach CV in the prescribed format.

7.5       Sub-Consultants
          Please provide details of any sub-consultants involved by you.
      Sl. No.                 Sub-Consultants                        Discipline




7.6      Joint Venture
         Please provide details of joint venture , otherwise state “NOT APPLICABLE”

7.7      Reference
         Please provide details of the companies/personnel from whom reference can
         be obtained for your the company.

7.8      Insurance
         Please provide details of possession of PL/PI Insurance (attach policy copy)




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                PRE-QUALIFICATION FORM – RA CONSULTANTS

8.0     Quality

8.1     ISO Accreditation
        Please confirm whether your company is ISO accredited? Provide details.

8.2     Quality Statement
        Please provide/submit your company quality statement?

8.3     Quality Assurance Manual
        Does your company have Quality Assurance Manual? If so, attach copies of
        the cover and table of contents pages.




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